MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 1 of 5)

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1 MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 1 of 5) COMPLETE SECTIONS (1-9) Merchant # Loc. 1 of Client s Business Name (Doing Business As): Signing Rep: Sales Office Phone: FAX: ( 1 ) TELL US ABOUT YOUR BUSINESS Client s Corporate/Legal Name (Use Also For Headquarters' Information): Business Address: Billing Address (If Different Than Location Address): City: State Zip City: State Zip Location Phone #: Location Fax #: Contact Name: Business Address: Contact Phone #: Contact Fax #: Business Website Address: Contact Address: Send Retrieval Requests / Fax Type to: Business Address Fax # SIC/MCC *If your business is classified as High Risk and assigned (or is later assigned based upon your business activity) any of the following Merchant Category's Codes (MCC): 4814, 4816, 5966, 5967, 7273, and 7841, the registration is required with Visa and/or MasterCard within 30 days from when your accounts becomes active. An Annual Registration fee of $500 may apply for Visa and/or MasterCard (total registration fees could be $1,000). Failure to register could result in fines in excess of $10,000 for violating Visa and or MasterCard regulations. 1 Registration for MCC7841 is only required for Non-Face-to-face adult content, 2 Information herein, including applicable MCC s, is subject to change ( 2 ) M C / V I S A / D I S C OVER NETWORK FULL SERVICE / AMERICAN EXPRESS Your Total Monthly Cash and Credit Sales: Your Total Monthly Cash and Credit Sales: (For All Outlets) Estimated MC/Visa Average Ticket / Sales Amount: Total Monthly MC/Visa Volume: (For All Outlets) Monthly MC/Visa Vol. for this Outlet: Estimated Discover Monthly Sales Volume (For All Outlets): Estimated High Ticket Amount: Estimated Monthly Sales Volume (For All Outlets): Estimated Monthly Sales Volume for this Outlet: Estimated Discover Average Ticket for this Outlet: Estimated Average Ticket for this Outlet: Estimated Discover Monthly Sales Volume for this Outlet MC/ Visa/ Discover Full Processing (3) ENTITLEMENTS (Discover Network systems and rules will process and govern JCB Transactions. Select Discover Full Processing if JCB is requested.) Voyager Fleet* Annual Voyager Volume: *Tax exempt Voyager Cards accepted: Yes No MC Fleet WEX Full Acquiring Annual WEX Volume: WEX (Non-Full Svc) Non-Lic. JCB (EDC) (Existing Account #) Debit Package (Existing Direct SE #) Cap # Franchise Name: Other: SE #: EBT FNS # (XREF): (4) PROVIDE MORE BUSINESS DATA State Incorp. Month/Yr. Started: Sole Ownership Partnership Non Profit/Tax Exempt Public Corp. Private Corp. L.L.C. Gov t. Check one: TIN Type: EIN (Fed Tax ID #) SSN D&B #: NOTE: Failure to provide accurate information may result in a withholding of merchant funding per IRS regulations (See Part IV A.4 of your Program Guide for further information.) Name (as it appears on your income tax return) Federal Tax ID#: (as it appears on your income tax return) I certify that I am a foreign entity/nonresident alien. Mag Swipe % + Keyed Manually % = 100% Product/Services You Sell: POS Card Present (MAG Swipe and/or Manual Imprint) % + Mail Order/Direct Marketing % + Phone Order % + Internet % = 100% Do you use any third party to store, process or transmit cardholder data? Yes No (Examples include, but not limited to web hosting companies, Electronic Data Capture, Loyalty programs) If yes, give name/address: Please identify any Software used for storing, transmitting, or processing Card Transactions or Authorization Requests: (5) DESCRIBE EQUIPMENT DETAILS Network: (206) CARDnet Nashville BuyPass Other Specify Security Code: ( ) Customer Owned Leased (Circle one) QTY IP Equipment Type (i.e. Terminal/ VAR/ Internet) Retail Restaurant MOTO/ Internet Lodging Supermarket Car Rental Quick Service Restaurant Petro Model Code and Name For Customer-Owned Equipment Track / Version/ Serial # NOTE: Any Special Instructions must be included on About Merchant s Business Page. Wireless Provider: GPRS Cingular or Other: Check one: Gateway Solutions Payeezy Global Gateway (GGe4) Dial Solutions VSAT*** Frame First Data Payment Software Serial # VAR/ Internet/ Software: Name: (Nashville Only: Product ID # Vendor ID # ***Requires separate agreement between VSAT Provider prior to implementation of this telecommunications protocol. PCS0417 Page 1 of 5 PCS0417 Client Initials

2 MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 2 of 5) DBA Name (6) P ROV I D E YOUR OWNER INFORMATION Owner/Partner/Officer Name: D.O.B: Social Security #: Home Phone: Title: % of Ownership Home Address: City: State: Zip: Owner s Address (Required for Click to Agree) Owner/Partner/Officer Name: D.O.B: Social Security #: Home Phone: Title: % of Ownership Home Address: City: State: Zip: Owner s Address (Required for Click to Agree) Start-Up Fees (One-Time Charge) Non-Taxable Fees: Application Fee (Non-Refundable) (247) Account Validation Fee (One-time fee charged at time of boarding) Reprogramming Fee Debit Set-up Fee (31A) (31B) Billed Monthly Fees Monthly Service Fee (335) $ Minimum Processing Fee (953) $ Wireless Access Fee Per TID (399) $ Monthly ClientLine Fee (32R) $ eids Monthly Fee (29E) $ Regulatory Product Fee (35I) $ Monthly Statement Fee (323) $ TIN/TFN Blank or Invalid Fee (181) $ (as applicable) Merchant Supply Advantage (413) $ Network Access Fee Debit (420) TranArmor Service Fee (30L) Enhanced Security Package Enhanced Security Pkg Monthly* ( ) OR Enhanced Security Pkg Annual* ( ) *Billing to start 2 months after contract date. (7) FLAT RATE / IC PLUS / TIER PRICING SCHEDULE Other Fees Authorization and AVS Fees Early Termination Fee $ MC Auth Fee (030, 031, 032, 033, 034, 03R, 03V, 03W, 03X, 03Y) $ Annual Membership Fee (294) $ Visa Auth Fee (040, 041, 042, 043, 044, 04R, 04V, 04W, 04X, 04Y) $ Chargeback Fee Retrieval Fee (205, 725, 20L) $ (262) $ Discover/JCB Auth Fee (070, 071, 072, 073, 074, 07I, 07V, 07W, 07X, 07Y) (080, 081, 082, 083, 084, 08V, 08W, 08X, 08Y) $ Batch Settlement Fee EBT Cash / Food Stamps (227) (029) Visa/ MC/ Disc Access Fee (241, 197, 526) Amex Auth Fee (060, 061, 062, 063, 064, 06I, 06V, 06W, 06X, 06Y) $ Amex Access Fee (26E) % MC/Visa /Discover/Amex Voice AVS Visa Auth Processing Fee (Credit) (04H) (039, 049, 069, 079, 03A, 04A, 06A) $ Visa Auth Processing Fee (Debit) (04J) MC/Visa/Discover/Amex Voice Auth Fee/VRU (035, 036, 037, 045, 046, 047, 065, 066, 067, , 077) $ NABU Fee TransArmor Txn Fee (60M, 0B4) (12E) ACH Reject Fee (401) AVS Fee (405, 406, 407, 408, 435, 07A, 07B, 07C) $ Non Return of Equipment Fee Payeezy Gateway Global Gateway e4 Payeezy Set-up Fee Per TID (40B) Payeezy Monthly Fee Per TID (40A) Payeezy Transaction Fee (OFC) Mobile Pay Wireless Comm Monthly Fee Wireless Transaction Fee (472) $ (434) $ Fleet Card Fees Authorization Fees Voyager (0D0, 0D1, 0DV) WEX (0D4, 0B1, 0BV) Other Payment Fees: Voyager Sales Fee (766) 3.95 % Wright Express Sales Fee (840, 841, 842, 843) 3.50 % Retrieval Fee (29I) $ Chargeback Fee (29H) $ Datawire Micronode 1400 Monthly Fee (each) (354) $ 4.25 Interchange fees will be passed through if applicable: MC Acq. CNP AVS Fee Acquirer AVS Billing, USD and non USD Cross border fee, Global Travel B2B,NCA IC fee, Proc Integrity Fee; Pre-Auth, Undefined, Image, Final-Auth, Auth- Min Fee, lic and Kilobyte Fee, Acct Stat Inq. Svc Interreg Fee, Dgtl Enable Fee, Loc Fee; Visa Int l Svc, Visa Int l Acq, Zero FloorLimit, Zero Amt, Kilobyte Fee, Misuse of Auth Partial auth NP Trans, US Debit Trans Integrity fee, Acct Stat Inq. Base II Credit voucher fee credit, Debit, Svc Interreg Fee Debit, SvcIntereg, NPF/FANF Visa CP, CNP (see IC qual matrix ( IQM ) for billing tables), Dgtl Wallet, B2B Virtual pmts product; Discover Int l Proc Fee, Int l Svc Fee, Data Usg Fee. Pass Through Interchange Includes Dues and Assessments. You will be charged the applicable interchange rate from MasterCard, Visa, or Discover plus a MasterCard Assessment Fee (273) of.12% a Visa Assessment Fee (274) of.13%, Visa Assessment Fee CR (27L) of.13% or a Discover Assessment Fee (234) of.13%, plus any other fees indicated on this Service Fee Schedule. (MasterCard Assessment Fee (237) when transaction is equal to $1,000 or more will be accessed an additional.02% per transaction). Network Fee (286) of.15% has Program Pricing and not Interchange and are subject to change. Sales Credit & Non-PIN Debit Transaction Fee _ (001, 002, 005, 006, 015, 016, 130, 131, 134, 135, 787, 788) Sales Credit Transaction Fee (013, 014) MC Qual Credit (800) MC Qual Non Pin Debit (850) Visa Qual Credit (804) Visa Qual Non- Pin Debit (854) Discover Qual Credit (170) Discover Qual Non-Pin Debit (964) Qual Credit (164) Program Cost (3AL) Bundled PIN Debit Unbundled PIN Debit Txn Fee Unbundled PIN Debit Fee (191, Key 0-593) $ OR (018) (Key 190, 590, 593) % (plus the applicable network fees) Debit PIN Debit Decline Transaction Fee (42R) $ PCS0417 Page 2 of 5 PCS0417 Client Initials

3 MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 3 of 5) DBA Name (7) FLAT RATE / IC PLUS / TIER PRICING SCHEDULE (cont d) Fee Transaction Fee Fee Transaction Fee MC Qualified Credit (800) _ (001, 002) Visa Non-Qualified Non-Pin Debit (864) _ (154, 155) MC Mid Qualified Credit (810) _ (611, 612) Discover Qualified Credit (170) _ (015, 016) MC Non-Qualified Credit (820) _ (621, 622) Discover Mid Qualified Credit (990) _ (717, 718) MC Qualified Non-Pin Debit (850) _ (130, 131) Discover Non Qualified Credit (994) _ (721, 722) MC Mid Qualified Non Pin Debit (870) _ (140, 141) Discover Qualified Non-Pin Debit (964) _ (787, 788) MC Non-Qualified Non-Pin Debit (880) _ (150, 151) Discover Mid Qualified Non-Pin Debit (968) _ (791, 792) Visa Qualified Credit (804) _ (005, 006) Discover Non Qualified Non-Pin Debit (978) _ (795, 796) Visa Mid Qualified Credit (814) _ (615, 616) Qualified Credit (164) _ (013, 014) Visa Non-Qualified Credit (824) _ (625, 626) Mid Qualified Credit (81C) _ (62T, 62U) Visa Qualified Non Pin Debit (854) _ (134, 135) Non Qualified Credit (82A) _ (65S, 65T) Visa Mid Qualified Non-Pin Debit (874) _ (144, 145) Program Cost (3AL) _ Flat Rate Transaction Fee Transaction Fee MC Qual Credit (800) % (001, 002) _ Discover Qual Credit (170) % (015, 016) _ MC Qual Non-Pin Debit (850) % (130, 131) _ Discover Qual Non-Pin Debit (964) % (787, 788) _ Visa Qual Credit (804) % (005, 006) _ Qual Credit (164) % (013, 014) _ Visa Qual Non-Pin Debit (854) % (134, 135) _ Program Cost (3AL) % Dues & Assessments (273,274,234, 237,286,27L) Billback Non-Qualified Surcharge Fee (excluding interchange pass-through fees, see Section 19.1) Applies to Non-qualified MC, Visa & Discover Credit and/or Non-PIN Debit Transactions. (30D) % Fees (Based On Gross Sales Volume) Accept all MasterCard, Visa and Discover Transactions (presumed, unless any selections below are checked) MasterCard Acceptance Visa Acceptance Discover Acceptance Accept MC Credit transactions only Accept Visa Credit transactions only Accept Discover Credit transactions only Accept MC Non-PIN Debit trans only Accept Visa Non-PIN Debit trans only Accept Discover Non-PIN Debit trans only See Section 1.9 of the Program Guide for details regarding limited acceptance. You are responsible for distinguishing Credit from Non-PIN Debit Cards. Even if you have agreed to limit your acceptance of certain cards as outlined above, you must continue to accept all foreign issued cards, whether Credit or Non-PIN Debit. If you agree to limit your acceptance to a particular type of card and, whether intentionally or in error, accept another type of trans action, the resulting transaction will down grade to the highest cost interchange plus the applicable Non-Qualified Sur charge (See Section 19.1 of the Program Guide). (8) AGREEMENT APPROVAL The statements made in this Merchant Processing Application and Agreement are true. Client acknowledges having received and reviewed a copy of the Program Guide (which includes terms and conditions for each of the services, Operating Procedures, Third Party Agreements and a Confirmation Page), Merchant Processing Application (consisting of Sections 1-9) as modified from time to time in accordance with the provisions of this Agreement and Interchange Qualification Matrix (IQM) and agrees to be bound by all provisions printed therein. The Program Guide and IQM are also available for viewing and/or downloading from the Internet at: Client hereby consents to receiving commercial electronic mail messages from us from time to time. Client further agrees that Client will not accept more than 20% of its card transactions via mail, telephone or Internet order. However, if your Application is approved based upon contrary information stated in the Provide More Business Data section above, you are authorized to accept transactions in accordance with the percentages indicated in that Section. By signing below, each of the undersigned authorizes us and our Affiliates to request and obtain from a consumer reporting agency, personal and business consumer reports. If the Application is approved, each of the under signed also authorizes us and our Affiliates to obtain subsequent consumer reports in connection with the maintenance, updating, renewal or extension of the Agreement. Each of the under -signed furthermore agrees that all references, including banks and consumer reporting agencies, may release any and all personal and business credit financial information to us and our Affiliates. Each of the undersigned authorizes us and our Affiliates to provide amongst each other the information contained in this Merchant Processing Application and Agreement and any information received from all references, including banks and consumer reporting agencies. It is our policy to obtain certain information in order to verify your identity while processing your account application. For ESA only Merchants: By signing below, I represent that I have read and am authorized to sign and submit this application for the above entity which agrees to be bound by the Card Acceptance Agreement ( Agreement ), and that all information provided herein is true, complete, and accurate. I authorize Petroleum Card Services and/or First Data Merchant Services LLC and Travel Related Services Company, Inc. ( AXP ) and AXP s agents and Affiliates to verify the information in this application and receive and exchange information about me personally, including by requesting reports from consumer reporting agencies, and disclose such information to their agent, subcontractors, Affiliates and other parties for any purpose permitted by law. I authorize and direct Petroleum Card Services and/or First Data Merchant Services LLC and AXP and AXP agents and Affiliates to inform me directly, or through the entity above, of reports about me that they have requested from consumer reporting agencies. Such information will include the name and address of the agency furnishing the report. I also authorize AXP to use the reports from consumer reporting agencies for marketing and administrative purposes. I understand that upon AXP s approval of the application, the entity will be sent the Agreement and materials welcoming it, either to AXP s program for Petroleum Card Services and/or First Data Merchant Services LLC to perform services for AXP or in AXP s standard Card acceptance program, which has different servicing terms (e.g., different speeds of pay). I understand that if the entity does not qualify for the Petroleum Card Services and/or First Data Merchant Services LLC servicing program, which the entity may be enrolled in, AXP s standard Card acceptance program and the entity may terminate the Agreement. By accepting the Card for the purchase of goods and/or services, or otherwise indicating its intention to be bound, the entity agrees to be bound by the Agreement. I further acknowledge and agree that I will not use my merchant account and/or the Services for illegal transactions, for example, those prohibited by the Unlawful Internet Gambling Enforcement Act, 31 U.S.C. Section 5361 et seq, as may be amended from time to time, or processing and acceptance of transaction in cretin jurisdictions pursuant to 31 CFR Part 500 et seq. and other laws enforced by the Office of Foreign Assets Control (OFAC) Client certifies, under penalties of perjury, that the federal taxpayer identification number and corresponding filing name provide herein are correct. THIS MERCHANT PROCESSING APPLICATION AND AGREEMENT HAS BEEN EXECUTED ON BEHALF OF AND BY THE AUTHORIZED MANAGEMENT OF CLIENT AS OF THE EFFECTIVE DATE. Client s Business Principal: (Please sign below) X Signature Print Name Date: Title: Pres. V.P. Member L.L.C. Owner Partner Other: (PROCESSOR): For Petroleum Card Services and/ or First Data Merchant Services LLC and Wells Fargo Bank, N.A. (a member of Visa USA, Inc. and MasterCard International, Inc.) X Signature Signature Title: Pres. V.P. Member L.L.C. Owner Partner Other: Print Name Date: ( 9 ) PERSONAL GUARANTY In exchange for Petroleum Card Services and/or First Data Merchant Services LLC and Wells Fargo Bank, N.A. s (a member of Visa USA, Inc. and MasterCard International, Inc.) acceptance of the Agreement, the undersigned unconditionally guarantees performance of the Client s obligations under the Agreement, and payment of all sums due there under, and in the event of default, hereby waives notice of default and agrees to indemnify the other parties for any and all amounts due from Client under the Agreement. I understand that this is a Guaranty of payment and not of collection and that Wells Fargo Bank N.A. Petroleum Card Services and First Data Merchant Services LLC are relying upon this Guaranty in entering into the Agreement. Signature (Please sign below): X, an individual Signature (Please sign below): X, an individual

4 MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 4 of 5) Bank Code: Merchant ID: BuyPass Merchant #: DBA NAME 24 (Characters) First/Last Contact Name at Bank: BANKING INFORMATION (REQUIRED) Phone Number: ABA #: DDA #: CHECKLIST INFORMATION Sales Support ID: Sales Rep. ID #: Print Sales Rep. Name: HIERARCHY: Bank: Agent: Corp. : Chain: BuyPass FIID: CLIENT VISITATION Visit Not Required (Lic. Professional) 8. Time Zone (required): 1. Zone: Business District Industrial Residential 9. Approx. Square Footage: ,000 2, Location: Mall Shopping Area Isolated Office Apartment Home 10. # of Employees: 11. # of Registers: 3. Seasonal: No Yes, Mos. in Operation: 12. Return Policy: Mos. Open Between to Full Refund Exchge Only None 4. External Facility Description (# of Levels/Floors): 13. Do you have a refund policy for your plus MC/Visa /Discover Network sales? Yes No If yes, Check one: 5. Merchant Occupies: Ground Floor Exchange Store Credit Refund Cardholder If MC/ Visa/Discover Credit, within how many 6. Remaining Floor (s) Occupied by: days do you submit credit transactions? Residential Commercial Combination Over 14 days 7. Advertising Name Displayed: 14. Proper License Visible (Liquor, Tax ID, etc.): Window Door Store Front Yes No, explain: 15. Your Previous Processor: 16. Your Previous Merchant #: 17. Check Reason for Changing: Rate Service Terminated 18. D & B #: 19. Do You Have Previous Processor MC/ Visa/Discover Statements? Yes No 20. Are customers required to leave a deposit? Yes No If Yes, % of deposit required: Time Frame for Delivery: Days Comments to Credit Officer (40 Characters): MAIL STATEMENTS/ DOCUMENTS Statement Recap Information: (check one) 01 = Outlet 02 = Stmt to Bill To/No Recap 07 = Suppress Stmt (No Stmt) 08 = Produce Recap, No Stmt 09 = Bill to Address/Stmt and Recap 10 = Recap to Bill To/Stmt to Outlet Statement Type: (check one) Detail Summary Statement Delivery Method: (check one) Online Print and Mail Statement Address: ON YOUR BUSINESS ACCOUNT CHECKING STATEMENT ROLLUP: (check one) 0 = Each Transfer 1 = Debit/Credit Grouped (By Category) 2 = Net Transfer Amount Only 3 = Net Transfer EOM Fee Combined PROCESSING INFORMATION 1. Processing mode: EDC: ECR 2. Funding will be processed DAILY via: ACH Bankwire 3. Bank will fund: Outlet Head Office 4. # of Plates: Long Short (will be shipped by ISO) 5. Fire Safety Act: Yes No 6. Ship Equipment and Welcome Packet to (will be shipped by ISO) (check one): Outlet Head Office Other, give mailing information below No Welcome Packet and Supplies No Welcome Packet Name: First/Last Contact Name: Address: City: State: Zip: PCS0417 Page 4 of 5 PCS0417

5 MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page 5 of 5) DBA Name Merchant ID: PROCESING INFORMATION (cont d) 7. Additional Terminal Features: (Check all that apply to ensure timely terminal programming) Auto Settle Time hh ET (military) Bar Tab Clerk /Server Entry Debit Cash Back Delayed Ship Date: Dial Prefix: Dial 9 Other: Dial Suffix: E-Commerce If IP (List Current Provider) Address: QSR-CR/SMT (Convenience/Small Ticket) QSR Print Option Invoice Number Multi-Trans (PC/Register/Software only) No Server/ Ticket ID Remove Room # Prompt Remove Ticket # Prompt Retail Gas Retail With Tip Ship Method (Overnight) Tip % Option Verify Amount Prompt Partial Approval Purchase w/balance Return Standalone Balance Inquiry Amex Prepaid Program Preference (Choose One): Partial Auth Balance Back Other PINPad: TDES Encryption DUKPT Access Code # Terminal Features: (Cont d) Key Disable or Credits Voids Forces Reviews Bal /Settle Auth Only Reports Tip Adjustment Password Protect Comments: (NOTE: Completing the Comments field will result in a 48 hour terminal programming delay) Mail / Telephone Order / Business to Business / Internet Information (All Questions must be Answered) 1. What % of total sales represent business to business (vs business to consumer): 2. What % of bankcard sales represent business to business (vs business to consumer): 3. What is the time frame from transaction to delivery? (% of orders delivered in): Business to Business % + Business to Consumer % = 100% (total sales) Business to Business % + Business to Consumer % = 100% (bankcard sales) 0-7 days % days % days % + over 30 days % = 100% 4. MC/ Visa /Discover sales are deposited (check one): Date of order Date of delivery Other (specify): 5. Who performs product / service fulfillment? Direct Vendor Other If vendor, add Name: Phone: Address: City: State: Zip: Please describe how the transaction works, from order taking to merchant fulfillment (attach additional sheet if necessary) : 6. Does any of your cardholder billing involve automatic renewals or recurring transactions (i.e., cardholder authorizes initial sale only)? Yes No PCS0417 Page 5 of 5 PCS0417